2011, Number 4
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An Med Asoc Med Hosp ABC 2011; 56 (4)
Appendiceal mucocele. Two case reports
Alarcón JGA, Shuchleib CA, Ylgovsky WL, Padilla RÁ, Chousleb KA, Shuchleib CS
Language: Spanish
References: 27
Page: 210-217
PDF size: 184.71 Kb.
ABSTRACT
The term of appendiceal mucocele refers to the cystic dilatation of the appendiceal lumen due to obstruction and consequent accumulation of mucus. It has an incidence of 0.2-0.3% of all appendectomies, and corresponds to 8% of all tumors of the appendix. Four histological subtypes are described: simple mucocele (retention cyst) 20%, mucosal hyperplasia 5-25%, cystadenoma 63-84% cystadenocarcinoma, 11-20%. When a perforation occurs the mucocele leads to the spread of mucous material in the peritoneal cavity: peritoneal pseudomyxoma. 10-15% of mucocele can lead to this entity, changing the evolution and prognosis. Studies that can lead to the diagnosis include x-rays, ultrasound, barium enema, abdominal computed tomography, MRI, colonoscopy, each one with specific characteristics. The treatment is surgery, laparotomy or laparoscopy. It is very important to be careful while handling the specimen, to prevent rupture and cell seeding. When it affects the tip of the appendix, while respecting the base, without local or cecal invasion the treatment is an appendectomy. But if the cecum is involved a right hemicolectomy must be preformed. Open surgery is usually the first choice in most hospitals, however minimally invasive surgery is an excellent choice in high-specialty centers. We report two cases one male (52y/o) and a female (48 y/o) both with a palpable mass in the right lower quadrant, one of them with a preoperatory radiological diagnosis, and the other during surgery. A right hemicolectomy was performed on both of them, to the female patient ooforectomy was added. The final report for the male patient was Mucinous Cystadenoma and Mucinous Cystadenocarcinoma for the female patient. She received adjuvant chemotherapy, the follow up after 6 years has been excellent and she is free of disease.
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